Bücker Lara, Schnakenberg Patricia, Karyotaki Eirini, Moritz Steffen, Westermann Stefan
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Clinical Psychology, VU Amsterdam, Amsterdam, Netherlands.
J Med Internet Res. 2019 Oct 2;21(10):e14240. doi: 10.2196/14240.
Self-guided internet-based interventions have several advantages over guided interventions and are generally effective in treating psychiatric symptoms.
We aimed to investigate whether the use of a new self-guided internet-based intervention (MOOD) would lead to a significant reduction in depressive symptoms compared with a care-as-usual (CAU) control group in a sample of individuals with depressive symptoms, most of whom had already used a different self-guided internet-based intervention in a previous trial.
A total of 125 individuals were randomized to the intervention condition (MOOD) and received access to the intervention for a period of six weeks or a CAU group. After six weeks, all participants were invited to take part in the post assessment. The Beck Depression Inventory-II served as the primary outcome.
Both intention-to-treat as well as per-protocol analyses indicated that the depressive symptomatology decreased in both conditions but showed no advantage for those who had used MOOD. Subsequent moderation analyses suggested that those individuals who had less experience with psychotherapy benefitted to a greater extent compared with those with more experience.
Self-guided internet-based interventions are deemed a suitable first-step approach to the treatment of depression. However, our results indicate that they are more efficacious in those with less psychotherapy experience.
ClinicalTrials.gov NCT03795480; http://clinicaltrials.gov/ct2/show/NCT03795480.
基于互联网的自助干预相对于有指导的干预有几个优势，并且在治疗精神症状方面通常是有效的。
我们旨在调查在有抑郁症状的个体样本中，与常规护理（CAU）对照组相比，使用一种新的基于互联网的自助干预（MOOD）是否会导致抑郁症状显著减轻，这些个体中的大多数人在之前的试验中已经使用过不同的基于互联网的自助干预。
总共125名个体被随机分配到干预组（MOOD），并获得为期六周的干预，或被分配到CAU组。六周后，邀请所有参与者参加后期评估。贝克抑郁量表第二版作为主要结局指标。
意向性分析和符合方案分析均表明，两种情况下抑郁症状均有所减轻，但使用MOOD的人没有显示出优势。随后的调节分析表明，与经验较多的人相比，心理治疗经验较少的人受益程度更大。
基于互联网的自助干预被认为是治疗抑郁症的合适的第一步方法。然而，我们的结果表明，它们在心理治疗经验较少的人中更有效。
ClinicalTrials.gov NCT03795480；http://clinicaltrials.gov/ct2/show/NCT03795480 。
